Introduction: Stroke is the second leading underlying cause of death globally and the leading cause of disability in adults. Stroke diagnosis should be performed quickly and efficiently to eliminate other potential causes of neurological deficits and to assess the time since the onset of clinical symptoms. Computed tomography (CT) and magnetic resonance imaging (MRI) are essential methods of detecting and evaluating stroke type and treatmentoptions. Diffusion and perfusion MR imaging is recommended for early stroke diagnosis, as well as for the selection of patients for recanalization therapy, and is considered effective in assessing treatment outcomes. The objectives of this study were to demonstrate the diagnostic value of diffusion and perfusion imaging in the diagnosis of acute ischemic stroke, analyze the role of magnetic resonance imaging in the selection of patients with acute stroke for recanalization therapy, and assess the effect of acute stroke complicity.Material and methods: The research is designed as a systematic review of the primary scientific research literature, which was published in English in relevant scientific databases (PubMed, Google Scholar, Medline) from 2014 to 2021.Results: 14 scientific research papers were singled out and the general characteristics of the study were analyzed (country, authors, year of publication, title of the study, type of study, study objectives, research methods, results and conclusion). A quality assessment of the included studies with cohort design and randomized controlled studies was performed, and most belong to the category of high-quality studies with a smaller number of medium-quality studies. The overall percentage of detected AIS cases in isolated studies using the DWI and/or PWI sequence was 90.8%. At the same time, the outcome of recanalization therapy was assessed using MRI studies (the number of patients who developed adverse events with functional data outcome 30 or 90 days after the procedure was observed). Comparison of MRI and CT imaging protocols provided data on the total percentage of detected acute stroke cases using CT imaging protocols (68.9%) and MRI imaging protocols (88.5%), which is why MRI is considered a superior method.Conclusion: Although CT is a suitable method for visualizing bleeding and also for early differentiation of hemorrhagic from ischemic stroke, if MRI imaging is available, it is recommended to use DWI, PWI, MRA sequences for a more accurate diagnosis of stroke in the acute phase.

Introduction: The knee joint has a unique anatomical structure in the human body. The localization between the two longest bones in the human body – femur, and tibia – makes it prone to injuries, trauma, and other pathologies. Clinical examination of the joint is still the primary method in evaluating the condition of the patient's knee. The study aims to determine the diagnostic accuracy of clinical examination and magnetic resonance (MR) in assessing chondral lesions of knee joint using arthroscopy as a reference standard.Patients and methods: The examination was conducted on 94 patients (58 males and 36 females) with knee injuries. Clinical examination indicated a primary chondral lesion of knee cartilage in eight patients (five men and three women), with an average age of 45.75. Besides the clinical examination, the diagnostics were performed using MR imaging by Siemens of 0.5 Tesla, and arthroscopy was performed using Storz arthroscope.Results: Our research has generated the following values of clinical and MR results for chondral lesions: Sensitivity (Se) = 12.5%, Specificity (Sp): could not be calculated, Positive Predictive Value (PPV) = 100%, Negative Predictive Value (NPV) = 0% and Accuracy (ACC) = 12.5%. The accuracy of clinical and intraoperative results for chondral lesion was: Se =100%, Sp: could not be calculated, PPV = 100%, NPV: could not be calculated, and ACC = 100%. MR imaging and arthroscopy findings of chondral lesion showed: Se = 100%, Sp = 0%, PPV = 12.5%, NPV: could not be calculated and ACC = 12.5%. In comparing the clinical sign and MRand intraoperative result, Positive Predictive Value for patients with chondral lesion was maximal (100%), while comparing MR with the intraoperative result, Positive Predictive Value was 12.5%. In comparison between clinical sign and intraoperative results, the accuracy for patients with chondral lesion was 100%, while comparing the clinical sign with MR result and MR with the intraoperative result, the accuracy was 12.5%.Conclusion: Our examinations have shown that MR examination is not currently as valid for diagnosing injury of chondral cartilage of knee as the medical community or patients have anticipated it.

Background: EMVI is a direct invasion of a vein by a tumor. As a predictor of hematogenous metastasis, it is a poor prognostic factor in rectal cancer and can be accurately identified on MRI prior to surgical procedure. Objective: To evaluate the role of contrast-enhanced T1-weighted magnetic resonance imaging (CET1WI) in addition to high-resolution T2-weighted imaging (HRT2WI) in assessing extramural venous invasion (EMVI) of rectal cancer. Methods: In all 195 patients with rectal cancer, HRT2WI and CET1WI sequences were produced within pre-operative MRI for the purpose of assessing for the presence of EMVI (mrEMVI). CET1WI sequences were produced following administration of Gadolinium contrast medium. mrEMVI assessment results were classified into two groups. Group A consisted of mrEMVI assessment results obtained using HRT2WI sequences only. Group B consisted of mrEMVI assessment results obtained using a combination of HRT2WI + CET1WI sequences. Results obtained for each group (A and B) were correlated with a histopathological finding (pEMVI) as a reference standard. Results: Out of a total of 195 rectal cancer patients, mrEMVI was positive in 41 (21%) patients in group A, and in 45 (23%) patients in group B. Histopathological finding demonstrated pEMVI in 54 (27.7%) patients. A statistical analysis of group A (HRT2WI sequences) resulted in 75.9% sensitivity to mrEMVI and 96.4% specificity, Positive Predictive Value of 89.1% and Negative Predictive Value of 91.2% (95% confidence interval (CI), p< 0.05). Statistical analysis of group B (HRT2WI + CET1WI sequences) resulted in 83.3% sensitivity to mrEMVI and 98.5% specificity, Positive Predictive Value of 89.1% and Negative Predictive Value of 91.2% (CI 95%, p< 0.05). Conclusion: T1-weighted magnetic resonance imaging (CET1WI) in addition to high-resolution T2-weighted imaging (HRT2WI) increased evaluation of extramural venous invasion (EMVI) of rectal cancer.

Introduction: Today film-based technologies are largely abandoned in dental radiology. New technologies based on digital detectors are being adopted. This change is part of the global digitalization of radiological procedures. A person operating the radiological device needs to be educated and well informed about radiological procedures and technologies, as well as to know how the system operates and to be sure about the dose required for the adequate image quality. The awareness of radiation doses received by patients is necessary for the estimation of risk from ionizing radiation. Material and methods: The aim of this study was to evaluate whether patient doses in intraoral dental radiology affect image quality. The study included subjective analysis of radiological image quality for an intraoral x-ray device with possibility to use both digital and film detector. Subjective assessment of image quality is performed according to criteria taken from the literature and is expressed using the Likert scale, grade 1–5. In order to improve the quality of inferential statistics related ratings to detector quality and image quality were collected, thus introducing two variables: the detector quality index and the technique quality index. Results: Z-test proportions column shows that the number of grades four given as a contrast score is significantly higher in the RVG detector (65%) compared to the film (40%). There is also a significant difference in the number of given grades five as a rating of the apex preview. The share of grades five in film is 19%, while in RVG it is 42%. It is similar in the evaluation of the preview of the dental canal, where there is also a significant difference in the number of given grades five, so that the share in the film is 11% and in RVG 35%. Conclusion: Analysis of the subjective quality of the radiological image in devices for intraoral radiography with the possibility of recording using digital and film detectors indicates that the digital detector is superior to film in low contrast resolution, apex and dental canal preview.

Introduction: Among the female population, breast cancer is the most commonly diagnosed cancer in the world, and nearly half of women population with breast cancer develop metastatic disease during their lifetime. Breast cancer most often metastazises to the lungs, liver, bones, brain and lymph nodes. 18F-FDG PET/CT can detect metastases that are not visible in other imaging modalities, and with the newly discovered lesions, decision about adequate treatment option can be evaluated. Material and methods: The examination was conducted as a retrospective descriptive study in May and June of 2019 at the Clinic for Nuclear Medicine and Endocrinology of the University Clinical Center in Sarajevo. It included 100 female patients with the age structure of 33-79 years. The patient's reference diagnosis is breast cancer, with a suspected finding of metastatic activity. A comparison of the sensitivity and specificity of the breast imaging between PET/CT, CT and bone scintigraphy was performed. Results: PET/CT revealed significantly more positive findings on metastatic activity than other diagnostic imaging modalities, with Mann-Whitney test value of p = 0.01014. In the diagnosis of lungs and liver lesions, PET/CT sensitivity and specificity are 92.59% and 85.37%, respectively, while the statistical parameters for CT are 77.78% for sensitivity and 90.24% for specificity. The PET/CT sensitivity and specificity for bone lesions are 93.55% and 88.89%, respectively, compared to 78.57% and 100% for bone scintigraphy. Conclusion: Hybrid imaging technique, which integrates PET and CT imaging methods, has considerable advantages over other diagnostic methods in the detection of distant metastases, and based on obtained results, PET/CT may be method of choice in evaluation of metastatic activity in breast cancer.

Vertebral artery (VA) fenestration is a rare vascular anomaly. It most commonly occurs in extracranial segments of the VA. This congenital anomaly can occur during the various stages of embryonic development of the VA. This usually does not have clinical significance, but the possibility of associated anomalies such as saccular aneurysms and arteriovenous malformations should be noted. Awareness of vascular anomalies is a key to avoid iatrogenic injury during endovascular diagnostic and therapeutic interventions. Here, we present incidental findings of VA fenestration in a 46-year-old woman evidenced by computed tomography angiography of the neck’s blood vessels after I.V. contrast medium applications.

In the study, the development of physiotherapy was described through the history and education in Bosnia and Herzegovina (BiH) with a special review on the significance of physiotherapy as a health-care discipline and the display of its development to the academic level of education in BiH.

Vertebral artery fenestration is a rare vascular anomaly. It most commonly occurs in extracranial segments of the vertebral artery. This congenital anomaly can occur during the various stages of embryonic development of the vertebral artery. This usually does not have clinical significance, but the possibility of associated anomalies such as saccular aneurysms and arteriovenous malformations should be noted. Awareness of vascular anomalies is key to avoiding iatrogenic injury during endovascular diagnostic and therapeutic interventions. Here, we present incidental findings of vertebral artery fenestration in a 46-year-old woman evidenced by CT angiography of the neck's blood vessells after I .V. contrast medium applications.

The clinical appliance of perfusion is being continuously developed and it is closely related to technology development. The role of perfusion neuroimaging in the management of acute stroke has been to prove reduced regional blood flow and to give the contribution in the identification of ischemic areas, respectively the regions of hypoperfusion that can be treated by thrombolytic and/or endovascular recanalization therapy. There are two main approaches to the measurement of cerebral perfusion by magnetic resonance. The aim of this article is to compare different measuring approaches of MR perfusion neuroimaging.

INTRODUCTION: Diseases of the locomotor system or musculoskeletal disease are on the rise, mainly due to the ageing of the population but also due to lifestyle changes. Those are the main cause of chronic pain and disability in the modern world. Thanks to the achievements of modern medicine, in patients with advanced osteoarthritis of the hip or knee it is possible to replace the diseased joint with an endoprosthesis, with very good long-term results related to pain reduction and function improvement. The aim of this study is to examine are there any differences in the quality of people's life before and after implantation of total knee endoprosthesis. RESPONDENTS AND RESEARCH METHODS: There were 30 subjects of both genders with knee joint disease enrolled in the study, who were treated with the surgical course at the Orthopedics clinic and the traumatology of the UKCS by implanting a total endoprosthesis, from the beginning of April until the end of October 2018. As an instruments of this research are used standardized SF-36 questionnaire for assessing the quality of life and overall health status and a modified questionnaire on the socio-demographic characteristics of the respondents. RESULTS: Patients after implantation of total knee endoprosthesis have a better quality of life, i.e. statistical significance at physical function level (P = 0.0001), role limits due to physical problems (P = 0.0001), social functions (p = 0.0001), energy or vitality (P = 0.0001), pain (p = 0.0001), limitations of the role due to emotional problems (P = 0.0001), and emotional prosperity (P = 0.0001) and general health (P = 0.004). CONCLUSIONS: The quality of life of patients was worse before the period after the total knee endoprosthesis, where statistically significant improvement was demonstrated.

The purpose of this study was to compare unenhanced MR angiography with contrast-enhanced MR angiography and visualisation of renal arteries with its segment branches using both techniques. We performed renal MRA on 22 patients using a 1.5T MRI unit. For renal MRA, a three dimensional balanced type steady-state free precession (SSFP) sequence (Time-SLIP, Canon) was used with respiratory gating and conventional CE-MRA sequnce (upisati tačan naziv). For analysis, two radiologists independently evaluated the visual quality of the axial images and axial maximum intensity projection images (MIP) of Time SLIP and CE MRA. Visualisation of aorta and main stem of the renal arteries were satisfactory on both techniques, and there was no statistically significant difference. The score of segmental renal artery appeared superior with Time-SLIP and showed a statistically significant difference (P<0.05). Visualisation of segmental renal arteries, interlobar renal arteries and kidneys parenchyma was significantly superiorwith Time-SLIP technique. We compared visualisation of renal arteries and its branches using unenhanced MRA, Time-SLIP, in comparison with contrast-enhanced MRA. Although it is slightly time-consuming and its clinical utility is necessary to further investigate, unenhanced MRA provides superior visualization of peripheral branches even in this study. Further improvement of the technique would make it even more sensitive in detecting small vessel abnormalities and it is promising for clinical use.

Introduction:Total hip endoprosthesis is one of the most frequent and effective methods that are used in the treatment of progressive degenerative hip changes. After the implantation of total hip endoprosthesis, patients perception on their postoperative improvement and health has big role in their contentment and thus in the success of the surgical procedure. The aim of this survey is to examine whether there are differences in the quality of life of people in third age before and after the implantation of total hip endoprosthesis.Material and methods:The survey included 100 examinees in the third age, above 65 years, of both genders, with the disease of hip joint that had been treated at the Clinics for orthopaedics and traumatology of UKCS by implanting the total endoprosthesis. The examinees were questioned before the surgery and after implanting the total hip endoprosthesis. The survey has covered the period from 1st January 2014 till 31st December 2016. As an instrument tool in the survey well validated SF-36 questionnaire for the estimation of life quality and total health status was used. Results: Evaluating all the elements in SF-36 questionnaire it was determined that statistically significant improvement of all the life quality elements that this questionnaire measured was detected, after the conducted surgery compared to the state before the surgery, p=0.001. Statistically biggest improvement has been detected in limitations that happened because of physical and emotional issues, and then in those that were related to physical and social functioning (p=0.001). Body pains and vitality are also statistically significantly better after the conducted surgery (p=0.001). Conclusion:Out of the results of the survey it derives that the quality of life of the people in third age is significantly better after the surgery of implanting the total hip endoprosthesis.